President Donald Trump promised to make health care "much less expensive and much better" shortly before his inauguration. So here's a reasonable question for Republicans pushing an Affordable Care Act replacement through the U.S. Senate at lightning speed: Why not give the nation's doctors, hospitals, nurses and patients enough time to see if the plan meets presidential expectations?
The Senate is now working on its own version of the Obamacare repeal plan passed by the House's Republican majority last month. Senators are making the same lofty but admirable promises as Trump. "Our goal for health care reform is to provide Americans with access to patient-centered health care and health insurance at an affordable cost with more choice and competition,'' North Dakota Republican Sen. John Hoeven said in a recent exchange with an editorial writer.
Asking to see how the Senate plan would do this — as stakeholders are demanding while a floor vote reportedly could come before July 4 — is not casting doubt on the party's intentions. Rather, it's a pragmatic acknowledgment that any health reform is complex and important, which is why it's past time for the Senate plan to be made public.
Health care encompasses about one-sixth of the U.S. economy, meaning it isn't just care that is at stake; it's jobs, too. Thirty million children depend on public assistance through Medicaid, which is being targeted for deep cuts by many congressional Republicans. It's also true that Obamacare reforms have left too many Americans who buy health insurance on their own facing few choices and skyrocketing premiums.
Fixes are needed, but they're also complicated, expensive and can have unintended consequences. That's why health reform is not a rush job. Instead, it's one that should be done with caution and in the full view of the public. It's also one that should deeply involve those on the front lines of patient care — America's world-class hospitals and medical providers.
Sadly, few outside a select circle of 13 Republicans crafting the bill know what is in it. Senate leadership just announced that the bill will be released Thursday. But Independence Day looms, and it is ludicrous to think this leaves enough time to air a lengthy, technical bill and ensure that all of those affected have had a chance to absorb it, much less weigh in on changes.
The Senate bill is reportedly similar to the House bill, which lacks the support of respected groups such as the American Hospital Association and would leave 23 million fewer Americans with coverage, according to the Congressional Budget Office. Polls also reveal dismal public support for the House plan.
The Senate's alarming lack of transparency only casts further doubt on the congressional reforms' value. Politicians who think concerns will magically melt away after the bill's passage are sorely mistaken. Those who respond to the criticism over their secrecy by blasting the ACA process for lack of transparency are disingenuous at best. That law's 2010 passage involved 79 House hearings and a 25-day Senate floor debate.
The Senate needs to slow down and convince Americans it is crafting a bill that merits wide support. So far, its process has only sown doubts.
